Permit CITY OF TIGARD FIRE PROTECTION SYSTEM PERMIT
11111 " 3 COMMUNITY DEVELOPMENT Permit #: FPS2012 -00021
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2439 Date Issued: 02/22/2012
Parcel: 1 S 135AB00900
Jurisdiction: Tigard
Site address: 10200 SW GREENBURG RD 340
Project: PNW Telco Subdivision: METZGER, TOWN OF Lot: 9
Project Description: TI
Contractor: CAPITOL ELECTRIC CO INC Owner: LINCOLN CENTER LLC
11401 NE MARX STREET BY SHORENSTEIN PROPERTIES LLC
PORTLAND, OR 97220 555 CALIFORNIA ST 49TH FL
SAN FRANCISCO, CA 94104
PHONE: 503 - 255 -9488 PHONE:
FAX: 503 - 257 -7121
FEES
Description Date Amount
Specifics: Permit Fee - COM 02/21/2012 $134.48
12% State Surcharge - Building 02/21/2012 $16.14
Type of Use: COM Plan Review - Fire Life Safety - COM 02/21/2012 $53.79
Class of Work: ALT Type of Const: IIB Info Process /Archiving - Lg $2.00 (over 02/21/2012 $10.00
Occupancy Grp: B Height: ft 11x17)
Stories: 7 Info Process /Archiving - Sm $0.50 (up to 02/21/2012 $3.00
11x17)
Houlry Building Rate 02/21/2012 $180.00
Commercial Sprinkler System: Hourly Building 12% State Surcharge 02/21/2012 $21.60
Sprinkler Required: Sprinkler Type:
Standpipe Required: Hazard:
Density: 0 Design Area: 0
K Factor: 0
Commercial Fire Alarm System:
Fire Alarm Required: Yes Alarm Type: Automatic
Pull Station Required: Smoke Detectors Req: No
Battery Calcs Provided: Yes Cut Sheets Required: Yes
Total $419.01
Valuations: Required Items and Reports (Conditions)
Sprinkler Valuation: $0.00
Residential Square Footage: 0
Fire Alarm Valuation: $5,060.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other
applicable law. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of
issuance, or if work is suspended for more the 180 days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon
Utility Notificaf . • - = .ter. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 -001 -0 90. You may obtain a copy of the rules
or direct qu- ions to O C • c. lin. 03.232.1987 or 1.800.332.2344.
Issued B 0 ja , Permittee Signature:
Call 503.639.4175 by 7:00 a.m. for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
.402/1 16:32 5032551966 CAPITOL ELECTRIC PAGE 02
illr Building Permit Application
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Fire Protection S y stem � � ` ��: , 1 U ()1 i i; ac ti:. rmi
Ci of Tigard ` � �� � R«civcd
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13125 SW Hall Blvd., Tigard, ORt9 � ° ��
Phone: 503.718.2439 Fax; 503.598.1 ` ,;. I ' "� " "' �,,t
Inapcction Line; 503.639.4175 \� Date • -: •� ''• ": el Sc e Page 2 for
Internet: www.tigard.or.gov Noti icwr c t o : n_ . Supplemental Information
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:. �- S 3 7.; 7,37c;',:::' - . : •- � { { rt 4 . x R '!"," .. . ... .� � C.7.,;-,-.7 • 1 . ,; 1G t
❑ New construction ❑ Demolition Permit fees' are based on the value of the work performed.
® Addition/alterotioNreplecxment ❑Other: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
43r, !,` 7 = ..r r work indicated on this lication.
- •k ... . 4 . �; ,. , u , „ Ir, n, " _� - .� ,r rkind' t application.
1:1 I- and 2- family dwelling ® Commercial /industrial Valuation: $
0 Accessory building ❑ Multi - family Number of bedrooms:
❑ Maater builder ❑ Oth Number of bathrooms:
t ]� .�-' ? _ " ,47 �` -^. ,T .,I 4: ! : � T I 4 c J um r 'r _ n - �f 1 , � _ , . , 4' - ,'' T Total number of floors:
Job site address: 10200 SW Grecnburg Rd New dwelling area: square feet
City /Ststo'ZIP: Tigard, OR 97223 Garagc/carport arca: square feet
Suite/bldg. /apt. no.: 340 I Project name: PNW Telco Covered porch area: square feet
Cress street/directions to job site: Deck area square foot
Other structure area: square feet
(Y.' ,. i `` i 1 , : * u + [ 16 , r., i
N, ,j I rte-.:. •J ' ti.
,' , Subdivision: I i.Ot no.: Permit lees* are based on the value of the work performed
indicate the value (rounded to the nearest dollar) of all
'C) Tax map/parecl no.: equipment, materials, labor, overhead, and the profit for the
" , . ; r' � ;n �ti I i ° i-� f work indicated on this application.
L 74:,- t".'- _ _ice. L . ::4 u r Y'�...: :. rr . _..'z' 1..S LY,G,i. C74:: ;1.4 m.di. �s �,
f.--,ye. 11 Valuation: $$5,060.00
—
\, Existing building area: square feet
New building area: square feet
'-"fu x m
\ r e
� Y�~:z ", �. v ",:„.. - -. :ti": r ' . -x'_V" ' -z Number of stories:
Name: Type of construction:
Imo, Address: Occupancy groups:
v\, City /State/ZIP:
Existing:
Phone: ( ) Fax: ( ) New 7,-"77.4..7.7,73--.7.: e'w'
1\ 11 4 e
I I ,G- C r r " ' s �+'. , .fi r , . ,'.: - ' hai „ S ',... - `�' 'S'� -' ; : no r . • ... f .......� . n (L r
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Business name: All contractors and subcontractors are required to be
Contact name: licensed with the Oregon Construction Contractors Board
under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City/State/ZIP: applicant is exempt from licensing, the following reasons
J Fax:: ( ) apply:
Phone: ( )
E-mail:
°: `,.. ^r++ . i k , , �, t i _ S f : .» c x :.:rte ' �`: �
-af : , -..; .., s . .. , -.... >r Crt � c. _� 4h� . + +, `,*'.. WZ -,.. -rv;.r 4i`�1. T, -nr ': 3:%z- '+I lips n7: I. a r 7 T'4 N.{r ;��T
a Business name: Capitol Electric Co ., Inc !' r J 1.L _.: .•1 ._ w�.._ L _;_' r��_7 .�L , i 2i.
Address: 11401 NE Marx 9t Permit fee: C , ��
IP: Portland, - State surcharge (12% of permit fee):
i i v I / „el
City /State2 rtland, OR 97220.1041
PIS plan review (40% of permit fcc): A.
Phone: (503) 255 -9488 I Fax: (503) 255 -1966 (Thee upon application.) 2 •
CCB lie.: 48748 Total permit foes: 138. .1J1)A0
Amoun received: .'
t i di
Authorized signature: / p 7
�`� This permit application expires if a permit is not obtained
Print name: Darrell Mcl eC 1 I Dote: 2/ 4/12 I within 180 days after it has been accepted as complete.
a Fee methodology set by Tri- County Building Industry
Service Board.
mauiid narrormi1a errs- ranmuApp.acc Roy 01/0542012 44o- 40137(11PoVJCOM/Wa5)
02/16/2012 16:32 • 5032551966 _ CAPITOL ELECTRIC PAGE 03
City of Tigard: Fire Protection Permit Checklist
Page 2 - Supplemental Information .
'13 n Irj q i t ���, s1 ': '� �+ 9 T --7r 7 r=M4� ,:'r,•� XCT -u' ,� --.'..
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L) ❑ New 2.) Modification to sprinkler heads only
O Addition ❑ 1 -10 heads: No plan review required.
❑ Alteration ❑ 11+ heads: Plan review required.
❑ Repair
Number of sprinkler heads: _
Additional description of work:
2 , 2 4 r � y TEL 1 m
, r n 6.+ ✓1 .'J l.�i ..� I ,� w�
u
' T�,�" 1 r� a ri`.
,., i.:1 ,,:,.. _._ .: �T3.� ....!:. =.. -rr •M., .s... ., �,"�i.i'
❑Wet ❑ Dry
Additional Standpipes
Information: Hazard Group
Density
Design Area
K. Factor
Sprinkler Project Valuation: $
r - 5 , / h + Y k j w - I 1 „�.r
1
- ru�•....1 r '..:. _, ._, . -m � - .t✓ .'�+ L . -. .+r.k.' «I.�r� 'rn. ' ��- - ,> �t. $, ` �..t5`tis.�.
Hood Project Valuation:
— ”` $
_Frr ' r' „i'4''S•r w ' r x .7' � 1;4 �+"•� A - x h om
k Sl A 1 Ira 67,7-; t j r, fY'ti rp ir . 7 *. 4-=44'
.4.
7�.�L� :.�3e'r .....0 -:S ..,,_.. ,C"a.,._. _. ! 1 .'' J, ...v TrC - .__ L � •� ��. ns. ���'.,�r`.�.'. _, �
Submittal shall Battery Calculations ® Yes
include: Individual Component 0 Yes
Cut Sheets
Fire Alarm Project Valuation: $ 5060
rr ' t L Y r �* ~ f x 't ��' s " ' 4 T ,tr' r d .& Y r '� - �'' r ✓, , r }7' F . ".°'
1747,7-7
�r5 �.1 - fjz� 1 _ IA -i 1 : r r '., �. �� F ♦ .. r.� k ? r4" a.•
—K-__, _. �w w � , .._.. .� �,:,: 1 ., a..,_.:..a t. _ _ —LI 1 ` L1_t, .r,-.s r �" (L;� 'i, .a•i' �,= �.. _
S • are Foo • - . Permit Fee:
0 to 2,000 $198.75
AA
2,001 to 3 600 $246.45
3,601 to 7 00 $310.05
7,201 and 1 . eater $404.39
Spriinider Project Square Footage: sq. ft.
r ... w + r• i - +4- u : t J-' "Y -- ^s4- ; . z „c 1: =
1 5•
1
yR .,1•: � �... '-°: . :if• ve T':h i •)= �:. i 1 i M1 acs �,s 'IL'. I i •�y
Project valuation subtotal see A B & C above : $ 5060
Permit fee based on_project valuation (see fee schedule): $ '1.314
Permit fee based on square footage (sec D above): $ r
State Surcharge (12% of permit fee): $ 0 '
FL 5 Plan Review (40% of permit fee): $ 36. -
TOTAL: $ 138.7 :.
Plan review requires a completed application and three (3) sets of plans at submittal.
Plan review fees arc requited at submittal.
hrtr/ /www•tigard -orgov /cry hull /depaxtmcnts /cd %does /FPS- Perm;r,App, Rcv01/05/2012
NFPA -72 Fire Alarm System Record of Completion
Date: 2/23/2012
•
' City of Tigard Information: Permit No. FPS2012 -00021
Name of protected property: PNW TELCO TENANT IMPROVEMENT, SUITE 340 @ 5LINCOLN
Address of protected property: 10200 SW GREENBURG ROAD TIGARD, OR
Representative of protected property (name/phone):
Authority having jurisdiction: City of Tigard, Building Services
Address/telephone number: 13125 SW Hall Blvd. Tigard, OR 97223 (503) 639-4171
1. Type(s) of System or Service
NFPA 72, Chapter 3 — Local
If alarm is transmitted to locations(s) off premises, list where received:
NFPA 72, Chapter 3 — Emergency Voice /Alarm Service
Quantity of voice/alarm channels: Single: Multiple:
Quantity of speakers installed: Quantity of speaker zones:
Quantity of telephones or telephone jacks included in system:
NFPA 72, Chapter 5 — Auxiliary
Indicate type of connection:
Local energy Shunt Parallel telephone
Location of telephone number for receipt of signals:
NFPA 72,
Alarm:
•
Supervisory:
NFPA 72, Chapter 5 — Proprietary
If alarms are retransmitted to public fire service communications centers or others, indicate location and
telephone numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 5 — Remote Station
Prime contractor.
Central station location:
Means of transmission of signals from the protected premises to the central station:
McCulloh Multiplex One -way radio
Digital alarm communicator Two -way radio Others
Means of transmission of alarms to the public fire service communications center:
(a)
(b)
System location:
Organization name /phone Representative name/Phone
Installer Capitol Electric Co. Inc. Dan W. Wilson 503 255 -9488
Supplier Capitol Electric Co. Inc. Dan W. Wilson 503 255-9488
Service organization Capitol Electric Co. Inc. Dan W. Wilson 503 2554488
Location of record (as- built) drawings:
Location of owners manuals:
Location of test reports:
A contract, dated , for test and inspection in accordance with NFPA standard(s)
No(s). , dated , is in effect.
2. Record of System Installation Suite 340 Only
(Fill out after installations complete and wiring checked for opens, shorts, ground faults, and improper
branching, but prior to conducting operational acceptance tests.)
This system has been installed in accordance with the NfPA standards as shown below, was inspected
by Jim Dotson on 02123/12 , included the devices shown below, and has been in service
since 02123/12 .
x NFPA 72 (2010), Chapters 10 12 14 17 18 21 23 (underline all that apply)
x NFPA 70 (2011), National Electrical Code, Article 760
x Manufacturer's instructions
_ Other (specify):
Signed: • �--5"' 0 Date: #REFI
Organization: Capito is Company, Inc.
3. Record of System Operation Suite 340 Only
All operational features and functions of this system were tested by Jim Dotson on 02/23/12
and found to be operating properly in accordance with the requirements of:
x NFPA 72 (2010), Chapters 10 12 14 17 18 21 23 (underline all that apply)
x NFPA 70 (2011), National Electrical Code, Article 760
x Manufacturer's instructions
Other (specify):
Signed: 'E.- Jim Dotson Date: 2/23 /2012
Organization: Capito tric Company, Inc.
4. Alarm- Initiating Devices and Circuits Suite 340 Only
Quantity and class of initiating device circuits (see NFPA 72, Table 3-5) Quantity: Style: Class:
MANUAL
(a) 0 Manual stations Noncoded, activating Transmitters Coded
(b) Combination manual fire alarm and guard's tour coded stations.
AUTOMATIC
Coverage: Complete: Partial:
(a) 0 Smoke detectors Ion Photo
(b) 0 Duct detectors Ion Photo
(c) 0 Heat detectors FT RR FT/RR RC
(d) 0 Sprinkler watertlow switches: Transmitters Noncoded, activating
(e) Other (list):
5. Supervisory Signal- Initiating Devices and Circuits Suite 340 Only
GUARD' S TOUR
(a) Coded stations
(b) Noncoded stations, activating transmitters
(c) Compulsory guard tour system comprised of transmitter stations and
intermediate stations
Note: Combination devices are recorded under 4(b) and 5(a).
SPRINKLER SYSTEM
(a) Non coded valve supervisory switch at sprinkler riser
(b) Non coded valve supervisory switch at sprinkler vault
(c) Non coded supervisory air pressure switch at sprinkler riser
(d) Site water supply level points
Electric fire pump:
(e) Fire pump power
(f) fire pump running
(g) Phase reversal
Engine -driven fire pump:
(h) Selector in auto position
(I) Engine or control panel trouble
(j) Fire pump running
Engine -driven generator:
(k) Selector in auto position
(I) Control panel trouble
(m) Transfer switches
(n) Engine running
Other supervisory functions(s) (specify):
6. Alarm Notification Appliances and Circuits Suite 340 Only
Quantity and class (see NFPA 72, Table 3-7) of notification appliance circuits connected to the system:
Types and quantities of notification appliances installed: Quantity: 6 Style Y Class: B
(a) Bells Inch
(b) Speakers
(c) Horns
(d) Chimes
(e) Other:
(f) 6 Visual signals Type: ADA SYNCHRONIZED
2 with audible 4 w/o audible
(g) Local annunciator
7. Signaling Line Circuits Suite 340 Only
Quantity and class (see NFPA 72, Table 3 -6)of signaling line circuits connected to system:
Quantity: Style: Class:
8. System Power Supplies (Notification Panel NAC:V3)
(a) Primary (main): NAC:V3 Nominal voltage: 120 VAC Current rating: 2.5 Amps
Overcurrent protection: Type: Circuit Breaker Current rating: 20 Amps
Location: FLOOR 3 ELECTRIC ROOM
(b) Secondary (standby):
X Storage battery: Amp -hour rating: 6.2 Ah @ 24 VDC
Calculated capacity to drive system, in hours: 3.143 Ah 24 60
Engine -driven generator dedicated to fire alarm system:
Location of fuel storage:
(c) Emergency or standby system used as backup to primary power supply, instead of using a secondary power supply:
Emergency system described in NFPA 70, Article 700
Legally required standby system described in NFPA 70, Article 701
Optional standby system described in NFPA 70, Article 702, which also meets the performance
requirements of Article 700 or 701
9. System Software
(a) Operating system software revision level(s): N/A
(b) Application software revision level(s):
(c) Revision completed by: WA
(name) (firm)
10. Comments:
Dan Wilson Capitol Electric Co., FLS Supervisor
(signed) for central station or alarm service company or installation contractor /supplier (title)
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):
This record of completion applies to Suite 340 Only
Devices installed conform to NFPA standards.
System deviations from the referenced NFPA standard(s) are: NONE
Dan Wilson Capitol Electric Co., FLS Supervisor
(signed) • r, - ntral station or ala pir "service company or installation contractor /supplier (title)
Upon • f etion of the . - m( test(s) witnessed (if required by the authority having jurisdiction):
(signer represwi e o e authority having jurisdiction (title) (date)